Diabetes is a disease in which blood sugar control is lost. Blood glucose levels rise, and hyperglycaemia is the hallmark of this disease. However, fat metabolism and integrity of blood vessels is also affected. A hormone called Insulin is secreted from the pancreas. The amount of insulin may be low or absent altogether or the patient may be resistant to insulin. In presence of insulin resistance, the endogenously produced insulin is ineffective in controlling blood sugar, instead, the insulin deposits fat around the belly and in the blood vessels.

This condition is very common in those who have migrated to this country from Bengladesh and parts of India and Pakistan. It is typically seen in those patients who are, “pear” shaped, i.e. big belly and small hips. If you have this shape then you must quickly seek advice and reduce your total fat intake and lose weight. As well as that, perform daily exercises, such as brisk walks at a speed of four miles per hour, for half an hour, i.e. two miles a day for at least five days a week. This may prevent development of diabetes and coronary artery disease.

Types of Diabetes Mellitus

Type 1 or IDDM or insulin-dependent diabetes, in which treatment is carried out by insulin injections. It mostly affects young children.

Type 11 or NIDDM or maturity-onset diabetes, in which blood sugar in controlled by diet or medicines. It mostly affects middle age people. Glucose- lowering drugs are called oral hypoglycemic agents.

Diabetes that occurs during pregnancy is called Gestational Diabetes. This type is common
in bulky and obese women. After childbirth, sugar level generally becomes normal. During pregnancy, it is important that blood sugar level is monitored regularly. Although diabetes commonly called, as `sugar` is a disease of middle age, it can occur at any age. This systemic disease may affect all parts of the body. It may damage small eye vessels and cause deficiency of oxygenated blood to the retina and consequently impaired vision. It may cause cataract, opaque lens of the eye, due to accelerated deposition of glucose by-products. Diabetes may also badly affect kidneys due to similar damage to the small blood vessels of kidneys. Due to generalised narrowing of blood vessels in diabetes, risks of angina, heart attack and strokes are likely to increase.

Obstruction in blood circulation may cause ulcers in leg and patients are asked to take care of their legs and feet because they are liable to get ulcerated. The patient is sent to chiropodist, who assists in foot care. Every big hospital has a diabetes centre in which diabetes specialist, expert nurses and other health professionals are on the same site for better care of diabetic patients. Similar centres are now set up in many general practices, thus providing for local and easy access and care.

Symptoms:

• Frequent passing of urine- polyuria
• Feeling of unusual thirst-polydipsia
• Abnormal appetite-polyphagia
• Feeling of weakness- debility

How To Treat Diabetes?

• by diet control:

In this mode of treatment, a patient keeps checking his/her sugar level in blood and urine
and always avoids eating sweet stuffs. He/she keeps check over his/her weight and consults his/her G.P in case of an emergency.

• by medicines:

In this method, different types of medicines are suggested which aims at increasing the quantity of insulin in the blood. The number and quantity of these medicines can be regulated according to doctor’s advice.

• by Insulin injections:

This mode of treatment is appropriate for those children and youngsters whose pancreas is not secreting insulin at all. The patient is advised about the quantity and time of taking insulin injections. It is an expansive and painful way of treatment as it is very important to monitor sugar level. In case of emergency, for instance in high fever, in infections or during mental stress, the quantity of insulin has to be increased. There are different types of insulin in the market these days. The insulin produced from biotechnology is relatively better as its after-effects are far less but it is notably expensive.

The psycho-social problems of diabetes

Mostly, the patients cannot bear with the idea that the disease has attacked them. That’s why, they find it difficult to change their diet and mode of living. Many patients of diabetes are short-tempered. Relatives of the patients are trained and provide help and support in treatment. Taking too much sugar or over-eating causes some people start blaming themselves as sinful that the disease is inflicted because of their some wrong-doings. Whereas we know that it is not the case. Had it been so, every single person would have been suffering from this serious disease.

Diabetes also causes depression and following are few symptoms of depression:-

• Feeling of helplessness
• Feeling loneliness.
• Exhaustion and irritation.
• Sleeplessness.

In this situation, your family doctor may send you to a psychologist. Many diabetes patients fear that they would never recover from this disease. This feeling is formed when the patient first comes to know of the affliction of this disease or its complications. To avoid this state of dejection, you should contact your family members, family doctor, faith healers and family friends. A diabetic patient may find it hard to secure a job. Though this kind of discrimination is unlawful but it often happens. He may also confront problems in getting a driving license. For the renewal of driving license, your GP can issue you a fitness certificate to drive your vehicle again.

The following tests should be carried out once in a year:

• Full eye test.
• Check-up of your feet.
• Complete check-up of kidney functions.
• Blood pressure.
• Fat levels in blood.
• Check-up of the methods of monitoring blood sugar.
• Check-up of the injection methods.
• Check-up of your eating habits.

Role of Modern Research

Recently, a watch has been invented to check the blood sugar, called Gluco-watch. The powerful sensor of the watch will detect the sugar in the blood and will display it on the dial, so in foreseeable future, the patients will get rid of the pricking pain of needles. Moreover, research is also being carried out on those things that can find the quantity of sugar in the blood without inserting syringes or needles in the body.

In near future, insulin would also be given through nasal sprays, so that the patient may not go through any pain. Medical scientists are researching on the genes of diabetes and it is quite possible that this disease will be treated through gene therapy. Scientists have found the genetic markers of this disease and that makes possible the screening of the relatives of diabetic patient because this disease also carries the hereditary element.

A single injection of insulin is sufficient for many weeks and months. This is called Depo Injection. Sufficient research is being put into effect on this methodology. Pancreatic grafting is being used in treating patients entirely depending on insulin. In this method of treatment, insulin-producing cells are patched into the body of the patient. Some of these operations have been very successful. The patient’s body rejects these additional cells. Thus, very strong medicines are used to stop this process. Besides being expensive, these medicines have adverse effects. Scientists, nowadays, are devising new ways of grafting pancreas because the patient’s body should not reject the insulin-producing cells. In this regard, scientists are applying bioengineering techniques to make artificial cells that can produce insulin to counter increase of blood sugar.
As far as media is concerned, awareness about diabetes among general public through newspapers, radio and television is being raised so that people should realise that this disease is not yet curable but we can control it. They are also being advised to take care of their diet, body weight and to take regular exercise to avoid this disorder. The people who have a natural tendency to become the victim of this disease are given warnings after having genetic screening tests. To escape this fatal disease, the principle, “prevention is better than the cure” should strictly be followed. After being a victim of this disorder, it is of utmost importance to control sugar level. If blood sugar level remains in control, it is still possible to live rest of the life normally.

For more information, please contact Diabetes UK
10 Parkway, London NW1 7AA

Telephone: 020 7424 1000

E-mail: info@diabetes.org.uk

Web Site: http://www.diabetes.org.uk